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Cerebral Palsy

Cerebral Palsy. Dr. Meg- angela Christi Amores. Cerebral Palsy (CP). diagnostic term used to describe a group of motor syndromes resulting from disorders of early brain development often associated with epilepsy and abnormalities of speech, vision, and intellect

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Cerebral Palsy

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  1. Cerebral Palsy Dr. Meg-angela Christi Amores

  2. Cerebral Palsy (CP) • diagnostic term used to describe a group of motor syndromes • resulting from disorders of early brain development • often associated with epilepsy and abnormalities of speech, vision, and intellect • selective vulnerability of the brain's motor systems

  3. Epidemiology and Etiology • the most common and costly form of chronic motor disability that begins in childhood • prevalence of 2/1000 • 80% of cases – antenatal factors causing abnormal brain development • <10% - had evidence of intrapartum asphyxia • High prevalence in low birth weight infants due to intracerebralhemorrhage

  4. Etiology • congenital anomalies external to the central nervous system • Intrauterine exposure to maternal infection (e.g., chorioamnionitis, inflammation of placental membranes, umbilical cord inflammation, foul-smelling amniotic fluid, maternal sepsis, temperature greater than 38°C during labor, and urinary tract infection)

  5. Periventricularleukomalacia

  6. Clinical manifestations - syndromes • Spastic hemiplegia • arm is often more involved than the leg • difficulty in hand manipulation is obvious by 1 yr old • Walking delayed until 18-24 mo • growth arrest, particularly in the hand and thumbnail • 1/3 have seizure disorder • 25% have cognitive abnormalities including mental retardation • MRI : Focal cerebral infarction

  7. Clinical manifestations - syndromes • Spastic diplegia • bilateral spasticity of the legs greater than in the arms • often noted when an affected infant begins to crawl • tends to drag the legs behind as a rudder (commando crawl) • scissoring posture of the lower extremities • Walking is significantly delayed • Excellent prognosis for normal cognition • Minimal seizures • MRI: periventricularleukomalacia

  8. Clinical manifestations – syndromes • Spastic quadriplegia • Most severe form • marked motor impairment of all extremities • high association with mental retardation and seizures • speech and visual abnormalities • MRI: severe PVL and multicystic cortical encephalomalacia

  9. Clinical manifestations – syndromes • Athetoid CP • also called choreoathetoid or extrapyramidalCP • characteristically hypotonic with poor head control and marked head lag • Feeding may be difficult, and tongue thrust and drooling • Speech is typically affected

  10. Diagnosis • thorough history and physical examination should preclude a progressive disorder of the CNS • MRI scan of the brain is generally indicated to determine the location and extent of structural lesions • tests of hearing and visual function

  11. Treatment • team of physicians from various specialties, as well as occupational and physical therapists, speech pathologists, social workers, educators, and developmental psychologists • no proof that physical or occupational therapy prevents development of CP • evidence shows that therapy optimizes the development of an abnormal child

  12. Treatment • spastic diplegia • assistance of adaptive equipment, such as walkers, poles, and standing frames • Quadriplegia • motorized wheelchairs, special feeding devices, modified typewriters, and customized seating arrangements

  13. Treatment • Communication skills • Bliss symbols, talking typewriters, and specially adapted computers including artificial intelligence computers • Drugs for spasticity: • dantrolene sodium, the benzodiazepines, and baclofen

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